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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This plan amendment updates the reimbursement rates for select Occupational Therapy codes, Physical Therapy codes, Speech Language Pathology codes and Audiology codes.
Summary: This amendment proposes to allow licensed professional counselors, licensed marriage and family therapists, and certified peer specialists to deliver services and be reimbursed by Federally Qualified Health Centers according to the Practitioner's Practice Act.
Summary: This plan amendment updates the reimbursement methodology for out-of-state nursing facilities to ensure continued access to nursing facilities for District Medicaid.
Summary: This amendment proposes to expand the scope of covered dental services that are available to individuals over age 21. Individuals over age 21 will receive the following medically necessary dental services: diagnostic, preventive, restorative, periodontal, prosthodontic, orthodontic, endodontic, emergency dental services, and oral surgery (inpatient and outpatient).
Summary: This plan amendment will permit the District of Columbia Medicaid program to reimburse public specialty inpatient hospitals at a rate that is fair and reasonable.
Summary: Will permit the District of Columbia’s Medicaid Program to increase the personal needs allowance standard for eligible institutionalized long-term care residents and set annual increases tied to the federal Cost-Of-Living adjustment (COLA) published by the Social Security Administration.
Summary: To update reimbursement methodology for Rehabilitation Day Services and Psychosocial Rehabilitation (Clubhouse) Services. To add screening, as a new service under the Mental Health Rehabilitative Services benefit. To rename Community Based Intervention Level 1, Multisystemic Therapy. To add a new service, Attachment and Biobehavioral Catchup, as a preventive service. To update the structure of Methadone Services in Opioid Treatment Programs.
